寄附用 郵便振替用紙希望FORM


会員ID (JpGU Member ID)
名前 (Name)
Family Name / Given Name
メールアドレス (Email Address)
住所 (Shipping Address)





Postal Code/ Prefecture(Select)/ Address line /The name of Building, Room Number/
連絡先 (Phone Number)
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備考 (Notes)
郵便振替用紙を希望します
I wish to receive a postal transfer form